I have been trying to analyze my emotions during this entire Terry Schiavo case. As an orthodox Jew, physician and a member of the human race it is quite clear that we are dealing with a case of euthanasia which is totally contrary to Jewish law.
Put simply, who are we to determine the relative value of life. The implications of deciding that an individual will not be cured or productive represents a slippery slope easily applied to tens of thousands of disabled from newborn to senior citizen.
One thing makes this case quite clear namely the absence of BRAIN DEATH. The sine queue non that indicates that a respirator may be discontinued is brain death. The findings of a totally flat EEG, THE FAILURE TO PERFUSE THE BRAIN ON CEREBRAL ANGIOGRAPHY, IN A TOTALLY NON-REACTIVE PATIENT are consistent with that diagnosis. The more modern techniques are nuclear flow studies to prove the absence of brain stem function such as pupillary (light reaction ), breathing etc. It is the absence of brain stem reflexes that differentiate brain death from brain injury.
BRAIN DAMAGED is not brain dead and is serious but may be compatible with life. Terry Schiavo WAS NOT BRAIN DEAD .
I am reminded of the Reform Rabbi while on a mission we took to the FSU informed me that he was a scholar in Jewish medical ethics, and had even published a responsa. I was quite shocked in view of his lack of observance of torah etc., and therefore pressed him for an example.
“Take a non-responsive individual on a feeding tube with no hope of cure’, he said, “one may take out the patients heart for a transplant.“ The reasoning he added was clear. “The purpose of life is to do mitzvoth (613 commandments) and since this person was unable to perform any mitzvoth, the patient was considered dead.” I decided to humor him and asked him to provide me with a copy of his response, so that I could give it to my personal Rabbi who was, like him, a professor in medical ethics. ”Who is your Rabbi?“ he asked. I answered, “Rabbi Moses D. Tendler, a Rosh Yeshiva, scientist and noted ethicist.” “Oh!" he answered. “He has already seen my response,…….and called me a MURDERER.”
INDEED!
Is this not Terry Schiavo? One week ago before she was dehydrated could we have removed her heart, lungs, liver, etc. for organ donations?
As an aside, Rabbi Moses Tendler who is not only my Rabbi, but my Professor of Genetics while at Yeshiva College has been outspoken and courageous in his insistence that oral suction of blood (mezizsh B’peh ) is not an integral part of the halachah of circumcision and for the safety of the child should have a plastic pipette used for suction. I myself when in practice saw one or two (I am not certain) cases of meningitis after mezuzah b’peh. The emotional attacks upon him have no place in serious discussions on human life.
So if the path is so clear why do I have such mixed feelings? Surely the circus media with so many crazies makes me uneasy. Perhaps it’s because as we get older we put ourselves in the place of Ms. Schiavo and we pray we will not have to suffer at the end of our days. Yes, we have faith in the Almighty, but yet no one wants to be a burden or a “vegetable.”
Thus, it is important that each of us has a health Care proxy/living will designating a competent individual who can make the difficult decisions with the guidance of proper and knowledgeable Torah authorities ,when we do not have that mental ability.
It is one situation for a 95 year old individual who tells his family that if he has a cardiac arrest he does not wish to be placed on a respirator (DNR) or have other extraordinary procedures performed, versus having placed the person on the respirator, and one week later trying to remove it (forbidden by halachah in a non brain dead individual).
The complex issues of stem cell research,,abortion, euthanasia, cloning, etc. are here to stay on the front pages of our society. The private rights of the patient to make decisions affecting their OWN life versus society, science, ethics, morality and halachah represent a growing area that will require calm and learned leadership from our religious teachers and the medical profession without the political circus that is currently underway.
NONE OF THIS MUST TAKE AWAY FROM OUR SENSITIVITY OF THE RIGHT TO DIE WITH DIGNITY, WITHOUT SUFFERING. There is a point in the life of terminal patients when the answer is a HOSPICE and not more surgery or experimental drugs. THE GOAL MUST BE DIGNITY AND COMFORT. THAT DOES NOT INCLUDE WITHOLDING NORMAL HYDRATION AND ALIMENTATION.
